Treating Venous Disease with Vein Ligation and Stripping
Our Heart & Vascular Services provide patients with the latest innovations in vascular care and clinical therapies. At University of Utah Health, our board-certified vascular surgeons specialize in treating all types of conditions that lead to venous insufficiency and varicose veins. We offer surgical and non-surgical treatment options to help you customize the treatment plan that fits your needs best.
What Is Vein Ligation & Stripping?
Vein ligation and stripping is a surgical procedure we use to remove veins that are severely damaged in the legs, which cause venous insufficiency or varicose veins. Once we remove the damaged vein, other veins in your body will take over to allow blood flow in that part of your leg(s).
Who Is a Candidate for Vein Legation and Stripping?
You might be a good candidate for this surgery if you:
- have severe venous insufficiency,
- have very large varicose veins,
- are at risk of getting venous skin ulcers or already have skin ulcers,
- experience frequent aching or heaviness in your legs,
- have severe leg pain,
- have a job that requires you to stand for long periods of time, or
- have veins that are damaged in places where superficial veins (those closer to the skin's surface) connect to deeper veins.
Your vascular surgeon may discuss other options instead of surgery if you:
- are older,
- have other medical conditions that put you at a higher risk for surgery complications,
- have poor circulation in the arteries of your leg (large blood vessels that carry oxygen from your heart to your body),
- have swelling or other fluid buildup in the area of your varicose veins because of lymphedema,
- have a skin infection,
- are at higher risk for blood clots, or
- are pregnant.
What to Expect at Your First Appointment
At your first appointment, you will meet with a vascular surgeon who will ask you about your medical history and discuss your concerns with venous insufficiency and/or varicose veins. They will examine your legs and look for other symptoms, such as swelling, skin discoloration, or varicose veins. Any symptoms that aren't visible, such as itching or pain, should also be discussed with your provider.
We may order an ultrasound to see what is happening inside your veins. We will run a small handheld device (called a transducer) over the top of your skin to see images of the veins inside your legs. These ultrasound images will help us create the best treatment plan for you.
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Vein Surgery: Ligation and Stripping
How to Prepare for Surgery
Vein ligation and stripping is a minor surgery. Most people can go home immediately after this procedure. You will be put to sleep under general anesthesia. It’s important to follow your surgeon’s instructions to prepare for surgery.
- Do not eat or drink anything after midnight the night before surgery.
- You may need to temporarily stop taking some of your current medications before surgery.
- If you smoke, stop at least one day before surgery (or sooner if you can).
Plan to have a family member or friend drive you to and from surgery. You will not be able to drive yourself after coming out of anesthesia.
Your surgeon and the anesthesiologist will meet with you before the surgery to discuss the procedure and answer any questions you have.
What Happens during Surgery
The procedure will take approximately one to two hours. Your vascular surgeon will make two small incisions (cuts)—one in the groin area (near the top of the damaged vein) and another in your thigh or calf (at the bottom of the vein).
Your surgeon will tie off the top of the vein to stop blood flow. A thin, flexible device will be threaded through the damaged vein. Your surgeon will use the device to pull the entire vein out through the incision (cut) at the bottom of the vein.
Once the vein is removed, the surgeon will stitch up your incisions and apply bandages to them. If you have other varicose veins in the same leg, your surgeon may make additional incisions (cuts) to remove these damaged veins. This procedure is called phlebectomy or microphlebectomy and can be done at the same time as vein stripping and ligation surgery.
After the surgery is complete, your surgeon will put gauze and an ACE compression wrap on your treated leg(s). You will be taken to a recovery room to rest and wake up from your anesthesia. You will stay in the recovery room for one to two hours before your family member or friend can take you home. Your surgeon will give you compression socks to wear the next day after the bandages come off.
Vein Surgery Complications
Vein ligation and stripping is a low-risk procedure that is safe for most people. However, like all surgeries, it does come with some risks. The most common risks include:
- infection after surgery,
- blood clots,
- scarring or bruising at the surgical site,
- injury to the nerves around your vein, or
- a reaction to anesthesia.
You will need to wear your compression stockings for approximately two to four weeks after the surgery while your leg(s) heal. Healing time may vary depending on the number of veins stripped and vein location. Your surgeon will discuss the healing process with you in further detail.
Signs of Healing After Surgery
- You may have some minor pain after vein ligation and stripping surgery. If necessary, you can take over-the-counter pain relievers to manage your pain. Your pain will get better as your legs heal.
- Most people have significant bruising immediately after surgery. Post-surgical bruises take up to three weeks to heal.
- It will take about three weeks for your incisions to heal and your stitches to dissolve.
Showering & Bathing After Surgery
- Do not shower until your doctor says you can take off the bandages and compression stockings, which is usually the day after surgery.
- Do not take a bath until two weeks after surgery or when your doctor says it is okay.
Resuming Daily Activities
Most people will be able to walk around within a few hours after their surgery. However, you will need to keep your legs elevated as much as possible for three to four days after surgery. As your legs heal over the next two to four weeks, continue to keep your legs elevated as much as possible while sitting down.
It’s important to move your legs and keep your blood flowing as much as possible once you are cleared by your surgeon to resume normal activity. We suggest you:
- walk around once per hour for 10 to 15 minutes at a time.
- flex and point your feet while you’re sitting or lying down.
- increase your exercise intake each day as your legs start to feel better and your incisions (cuts) heal.
Do not do any strenuous exercise such as heavy lifting until you are instructed to safely do so by your surgeon.
Driving & Returning to Work
You will not be able to drive for at least three days. Talk to your doctor about when you can resume driving. Most people can go back to work after one week of recovery. If your job involves physical strain, standing for long periods of time, or other activities that could put stress on your legs, your doctor may tell you to wait longer before going back to work.
Vein Ligation and Stripping Success
Vein ligation and stripping surgery has a high success rate. Most people who get this procedure do not need any additional treatment for venous insufficiency. However, you may need additional phlebectomy or microphlectomy procedures to remove any varicose veins in your legs. It's possible to develop venous insufficiency or varicose veins in other veins over time. If that happens, you might need additional treatment, such as compression socks or another surgery.
Request an Appointment with a Vascular Surgeon
Call 801-585-7676 to meet with one of our vascular surgeons.
A referral is not required to see a vascular surgeon at University of Utah Health. However, some insurance plans may require a referral from your primary care provider (PCP) to see a specialist. Check with your insurance carrier if you have any questions about your coverage.